1285191825 NPI number — PINNACLE HOME CARE OF THE PALM BEACHES, LLC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285191825 NPI number — PINNACLE HOME CARE OF THE PALM BEACHES, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PINNACLE HOME CARE OF THE PALM BEACHES, LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285191825
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4023 TAMPA RD STE 2200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OLDSMAR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34677-3212
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-814-6000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
579 NW LAKE WHITNEY PL STE 103
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORT ST LUCIE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34986-1622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-814-6000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/01/2019

Additional Information

Authorized Official

Authorized Official Last Name:
LAFER
Authorized Official First Name:
MAX
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
813-814-6000

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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